Help for a 3 and a half year old!

[JD1988]

My 3 and half year old has been suffering with a cough ALL year. Shes had numerous flare ups and everytime we have been to the doctor they say its her asthma. She was given a steroid inhaler, blue inhaler and montelukast but this cough has never returned back to normal (sounds like a bark, chesty cough) she coughs so much she makes herself sick. The doctor said her lungs were clear so i have no idea what shes coughing up? Shes not wheezy either. Ive done and tried everything i can to help her and been sent for lots of covid tests which all come back negative. Can anyone relate? Or could this be something else?

[Poobah]

This sounds like cough variant asthma; a non productive persistent cough, without wheezing. Not uncommon in children and categorised as an asthma sub type. But as with most asthma, treatment is steroid inhalers, reliever inhalers and medication to address allergies. This doesn't mean that this treatment is going to be successful and the fact that the cough persists has made you question the diagnosis of asthma.

This is a useful article that considers the causes of a persistent dry cough; uofmhealth.org/health-libra...

And advice from Asthma UK; asthma.org.uk/advice/child/...

It's so difficult to establish irritants and triggers in adults who can vocalise what their experience is like, but trying to extract that information from a toddler is extremely challenging. Being observant about the cough symptoms, when they occur, what days/nights that are worse, what potential irritants were around during the day or night can build a picture of triggers in the house or elsewhere. Food and drink can play a part, as can digestive reflux or post nasal drip.

It could be post viral hypersensitivity; covid isn't alone in causing long term symptoms.

Not all asthmatics respond well to all asthma meds. We all have to try a variety of preventer inhalers before finding the one that suits us best, unless we're lucky to get the right one straight away. Some find using a spacer to take their inhalers beneficial and there are child sized spacers, but I suspect that you may already have one. Having a regular review with an asthma nurse can help you navigate through the treatment minefield.

The only other thing I can think of, that may help but can make things worse, is a salt lamp. Again, it's trial and error. Salt can be an irritant but, for some, can be beneficial. I would avoid essential oils and other strongly perfumed plug ins, aerosols etc. Washing powders and perfumed softener in laundered bed linen should be avoided. Apologies if you've already gone down this road.

I'm sure others will have good suggestions.

[JD1988 in reply to Poobah]

Thank you so much for your reply. I dont use diffusers or plug ins because they irratate me. The only thing i havent tried is changing the laundry powder so im 100% going to give that a try. 😀

[Poobah in reply to JD1988]

I've spent a lifetime channeling Sherlock Holmes to try and figure out my own triggers, from toothpastes to wood burning fires. It's a complex world! Good luck.

[pink123floyd in reply to JD1988]

Sorry to hear your baby is so unwell if you are going to change your washing powder try Evo its liquid form and i have been using it for quite some time do to my bedding being bamboo but have noticed i don't cough as much as i use too of a night and there is only a fresh smell on my washing as i am allergic to perfume smells and such after having a chronic cough for 15 yrs its now easing and i'm no longer cracking ribs due to the force of the cough best of luck and stay safe .xxx

[Bevvy in reply to Poobah]

Can I just say you need to be REALLY careful with salt lamps. I decided to try one a couple of years ago after reading good reviews but with a warning from reviewers. I used mine once then threw it away. It became extremely hot and I was concerned there was a risk of fire with it. Certainly would be very wary of using it in a child’s bedroom….I agree with Poobah that often it is a case of trial and error. Search on this site and telephone asthma nurses here who may be able to give helpful suggestions. For example I seem to remember cuddly toys could be problematic and someone advised regularly putting them in a freezer….?!

[Poobah in reply to Bevvy]

Agree. So difficult to buy genuine stuff online, and even then a salt lamp maybe a trigger rather than a solution.

[Mariachristina76]

Have a barky cough for 6 years. I was told a few months ago it was over my acid reflux by a doctor in the hospital.

[Itswonderful]

Yes I can relate. I’m so sorry your baby is going through this. Humidity levels can play a part, noticing if the cough is better or worse when the air is moist and dry may be helpful then you can rectify accordingly. Having an air purifier may or may not help. Not an ionising one, but one that simply filters the air. Fabric softeners can be problematic as well as laundry powders/ capsules. The temperature of the air can also be problematic though if she has benn coughing all year it may not be a trigger. Food and drink can be triggers so sugary foods and drinks, fizzy drinks, fried foods and others can cause acid reflux that irritates the throat. And as already mentioned, post nasal drip can do the same. Perhaps you could ask for a referral to a paediatric speech and language therapist as this can be very helpful? I hope it settles soon. Best wishes.

[Hidden]

Does she have a soft toy that she likes to cuddle? I ask because these can be a very potent source of dust mites which are a known trigger for asthma. If she has try putting the soft toy in a plastic bag and putting it in the freezer for a while. That can help to control the dust mite population.

[Naturesvalley]

Hi. Have recently been diagnosed with asthma as a result of covid. I have been on montelukast for over a year off and on because of a chronic cough especially at night. It does help to suppress the cough but I have been let with a strange tickle in my throat especially in the early morning. I also cough constantly. I am now on montelukast permanently.